A case of invasive lobular carcinoma of the breast first manifesting with duodenal obstruction
Tóm tắt
Lobular carcinoma of the breast presents with various clinical manifestations. Lobular carcinoma comprises about one fifth of cases of ductal carcinoma. Intestinal metastasis is dominant in cases of lobular carcinoma. Without a prior diagnosis of lobular carcinoma of the breast, the diagnosis of intestinal metastasis from breast cancer is difficult. A 52-year-old women underwent duodenogastrectomy for duodenal cancer. About 18 months later, she underwent mastectomy for lobular carcinoma of the breast. The duodenal cancer consisted mainly of malignant cells invading the submucosa that were identical to those in the breast. Immunohistochemical assays for estrogen receptor also confirmed breast cancer metastasis. Duodenal obstruction was the first sign of isolated metastatic lobular carcinoma of the breast in this case. The characteristic metastatic pattern of lobular carcinoma, which differs from that of ductal carcinoma, should be kept in mind to ensue proper diagnosis. Preceding breast surgery for lobular carcinoma should prompt investigation based on the typical metastatic pattern.
Tài liệu tham khảo
Hellman S, Harris JR: Natural history of breast cancer. In: Harris JR, Lippman ME, Morrow M, Osborne CK, eds, Diseases of the breast, 2nd ed, Lippincott Williamas & Wilkins, Philadelphia, pp 407–423, 2000.
Schnitt SJ, Guidi AJ: Pathology of invasive breast cancer. In: Harris JR, Lippman ME, Morrow M, Osborne CK, eds, Diseases of the breast, 2nd ed, Lippincott Williamas & Wilkins, Philadelphia, pp 425–470, 2000.
Borst MJ, Ingold JA: Metastatic patterns of invasive lobular versus invasive ductal carcinoma of the breast.Surgery 114:637–641, 1993.
Goldstein NS: Does the level of E-cadherin expression correlate with the primary breast carcinoma infiltration pattern and type of systemic metastasis?Am J Clin Pathol 118:425–434, 2002.
Lamovec J, Bracko M: Metastatic pattern of infiltrating lobular carcinoma of the breast: an autopsy study.J Surg Oncol 48:28–33, 1991.
Reiman T, Butts CA: Upper gastrointestinal bleeding as a metastatic manifestation of breast cancer: a case report and review of the literature.Can J Gastroenterol 15:67–71, 2001.
Schwarz RE, Klimstra DS, Turnbull AD: Metastatic breast cancer masquerading as gastrointestinal primary.Am J Gastroenterol 93:111–114, 1998.
Daniels IR, Layer GT, Chisholm EM: Bowel obstruction due to extrinsic compression by metastatic lobular carcinoma of the breast.J R Soc Health 122:61–62, 2002.
Azzarelli A, Clemente C, Quagliuolo V, Baticci F: A case of pancreatoduodenectomy as resolutive treatment for a solitary metastasis of breast cancer.Tumori 68:331–335, 1982.
Pappo I, Feigin E, Uziely B, Amir G: Biliary and pancreatic metastases of breast carcinoma: is surgical palliation indicated?J Surg Oncol 46:211–214, 1991.
Lottini M, Neri A, Vuolo G, Testa M, Pergola L, Cintorino M, Guarnieri A: Duodenal obstruction from isolated breast cancer metastasis, a case report.Tumori 88:427–429, 2002.
Houghton AD, Pheils P: Isolated duodenal metastasis from breast carcinoma.Eur J Surg Oncol 13:367–369, 1987.
Kummar S, Ciesielski TE, Fogarasi MC: Management of small bowel adenocarcinoma.Oncology (Huntingt) 16:1364–1369, 2002.